Approved at the General Assembly in Vienna on 30 September 2023
World Psychiatric Association (WPA) Position Statement: Mental Health in the Workplace
2022 // GA23.10.6
Purpose of Statement
This Position Statement focuses on the important role that ‘good work’ [defined below] can have on
an individual’s mental health. It highlights the role of workplace in fostering positive mental healthand prevention of mental health disorders. The Position Statement draws attention to the risks posedby a poor work experience for people with existing mental health problems and provides
recommendations to key organisations and individuals who have a role to play in promoting mentally
healthy workplaces.
The WPA believes that supporting individuals with mental health disorders in the workplace positively
contributes to their recovery, social inclusion, and improved quality of life. Furthermore, occupational
environments that foster good mental health are associated with greater social and economic
prosperityi through healthier more productive workers.
All healthcare professionals should formally consider whether employment is a precipitating and/or
maintaining factor in someone’s mental health disorder. Furthermore, clinicians should view being ingood work as a key treatment outcome for people who are of working age.
Authors
Professor Neil Greenberg (UK) - Chair
Professor Norito Kawakami (Japan)
Dr Thirumalai Rajgopal (India)
Dr Richard Heron (UK)Dr Joshua Morganstein (USA)Dr Rakesk Jetley (Canada)
Professor Nick Glozier (Australia)
Background
Mental health problems are a leading cause of work disability and economic lossii across the globe.
Access to work is a central concern with significant, negative impacts for a large proportion of people
with mental health problems. These include social exclusion, and a lack of meaning to their lives, andthe wider effects of poverty on their health and the wellbeing of their families.

Good work is associated with better mental health, yet people with mental health problems are often
excluded from the workplace or find themselves in precarious work. Furthermore, poor mental healthis associated with absenteeism and presenteeism (reduced occupational functioning). This is aparticularly important consideration for those in safety critical roles.iii Supporting short- and long-term
recovery from mental health conditions often involves addressing the employment, educational andbenefits needs of patients. Ensuring that working age adults can find, and remain in, employment
requires multiple, diverse stakeholders to work collaboratively with the aim of promoting mentally
healthy workplaces and supporting people with mental health problems to access, and remain in,good work.
What is good or appropriate work?
Good work is work which is appropriate to an individual’s knowledge, skills, and circumstances, andundertaken in a safe, healthy, and supportive working environment; it promotes good physical andmental health, helps to prevent ill-health, and can play an active part in helping people recover fromillness. Good or appropriate work also rewards the individual enhanced self-worth and beneficial
effects on social functioningiv.
Stressors in the workplace
Workers’ mental health may be adversely affected by many types of stressful experiences at work.
These can be associated with the context of their work (the demands from it, levels of control orautonomy over it, manager support, role clarity, interpersonal relationships and the impacts fromchanges at work). Some occupational groups such as healthcare staff, military, emergency services
are also routinely exposed to traumatic situationsv. Stressors that originate outside of the workplace,such as family or relationship difficulties, health problems or bereavement can also impact mental
health at work - all sources of stress have the potential to adversely affect someone’s mental health.
By addressing workplace stressors and supporting people with non-work related stressors, the mental
health of working adults can be improved together with the productivity of the organisation.
Recommendations
The following actions by various individual and organizational stakeholders to foster good mental
health for people of working age are recommended by the WPA:
National and Local Governmental Organisations should
1) Require employers to have policies and guidelines in place that address the risks to workers’
mental health and promote workplaces that foster good mental health.
2) Require employers to make reasonable adjustments so that people with mental healthdifficulties are able to work.
3) Ensure that occupational health capacity is available for timely access to advice for workers
with mental health problems that helps them access, remain in or return to good work.

4) Make available vocational support services for patients with mental health problems to help
them access, remain in, or return to, work.
5) Incentivise employers to offer people with mental health disorders (especially chronic orfluctuating conditions) more flexible working arrangements, time off work (short-term
disability/sick leave) and access to support services without adversely impacting theiremployment.
Employers should
1) Adopt policies and practices which actively assess and manage the risks to mental health atwork, with a primary focus on occupational stressors.
2) Support people who develop mental health conditions to remain in, or return to, good work.
3) Create a culture that encourages early engagement in help-seeking behaviours and lowers
barriers to care, including stigma and fear of reprisals in the workplace.
4) Enable their staff to access occupationally focused mental healthcare needed to help theirstaff remain in, or return to, good work.
5) Ensure that all managers have the skills, attitudes, behaviours, and confidence to identify
potential mental health difficulties in their staff vi and are able to guide them towards
appropriate support pathways.
6) Ensure that workplaces foster a culture of mutual care and enable peer support amongstworkers.
Healthcare Providers should
1) Ensure they have a broad awareness of the nature of someone’s work and the risks that it
poses to their mental health.
2) Understand the close links between the people’s mental health and their ability to work. Thisis especially important when providing care for people with safety critical roles [e.g., vehicle
operators, emergency services etc.]
3) Ensure that all healthcare staff provide care in a way that helps working age adults to stay in,or return to, good work.
4) Ensure that all healthcare staff understand the key role of occupational health services insupporting patients accessing, remaining in, or returning to, good work.
5) Ensure that healthcare staff provide care in way which recognises being in good work as a key
treatment outcome for working age adults.

Mental Health Professionals should1)

2)

Ask about their patients’ work history, including their current work status, current andprevious occupational stressors, to understand what role work may have played incontributing to their mental health.
Recognise that helping their patients to access, remain in, or return to, good work is an
important treatment outcome.

3)

Encourage their healthcare colleagues to recognise the mental health benefits of being ingood work and consider work a key treatment outcome for any care provided.

4)

Advocate for their patients by appropriately communicating with employers, and other
involved professionals, to challenge any discrimination or stigma that exists about mental
health with the aim of helping their patients to access, remain in, or return to, good work.

Specific considerations for mental health professionals
1) Routine assessment of employment and education history
An employment and education history should be a part of routine clinical assessment for those ofworking age. This information should be an easily accessible part of patient records and updated
regularly. An exploration of the relationship between symptoms, work and education, and the impact
of symptoms, and medication, on occupational and social functioning is essential when patients arerecovering. Asking about future hopes for work, education and training is key - wanting to return towork is the strongest predictor of a return to work after illness.vii Mental health professionals should
aim to facilitate a return to good work wherever possible, taking into the account the wishes of theindividual and the nature of the work that they do.
2) Define work-related treatment outcomes
It is important that mental health professionals see work, work-related activities and education, as
desirable treatment outcomes for all working-age patients. Discrimination against people with mental
health problems, in particular severe mental illness, continues to be a major barrier to work. Yet, there
is strong evidence that employment support enables people with severe mental illness to return towork. Vocational rehabilitation programs such as Individual Placement and Support have positive
employment and health outcomes and strong efforts should be made to ensure all those of working
age have access to them.viii3) Address work-related challenges
Work may be the first place that symptoms become unmanageable for people with mental healthproblems. This is often associated with mistakes, poor performance or a breakdown of relationships
at work. It is not unusual for patients to feel a sense of embarrassment, humiliation and reducedconfidence. Return to work can be extremely difficult without mental health treatment andoccupational support. Ensuring that return to work is a key treatment goal can help, as can appropriate
liaison with someone’s workplace to ensure that any reasonable adjustments are considered andappropriately implemented. Mental health professionals may need to act as advocates for theirpatients, with employers or other professionals, to optimise the likelihood that individuals can worksafely and effectively.

4) Support patients with employment and disability rights
Mental health professionals need have a working awareness of employment support and disability
rights so they can support patients to know their rights in the workplace. People with mental healthproblems are often marginalised and unaware of available support and disability legislation.
Employment support within mental health services offers a key opportunity to support recovery frommental health problems. Employment support embedded within mental health services has beenshown to be effective at helping people, even those with considerable barriers, move into work.ix
Research has demonstrated that employment support is often not offered or available to mental
health services users, and that this is even more pronounced for some marginalised groups.x
Summary and Conclusions
Fostering psychologically healthy workplaces requires timely, effective, and ongoing collaboration
between key stakeholders. When this is achieved, working age adults can thrive individually withconsequential positive impacts for employers, and the economies of the nations in which they work.
Whilst national and local governmental organisations and employers have important roles to play, it
is also essential that all healthcare staff consider the impact of health on work and work on health inorder to provide the most effective care possible for their patients.

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